Provider Demographics
NPI:1942325451
Name:GLUSHAKOW, ADAM L (MD)
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:L
Last Name:GLUSHAKOW
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:ADAM
Other - Middle Name:L
Other - Last Name:GLUSHAKOW
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:200 HYGEIA DRIVE
Mailing Address - Street 2:SUITE 2300
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:501 WEST 14TH STREET, WILMINGTON HOSPITAL
Practice Address - Street 2:DEPARTMENT OF PSYCHIATRY
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19801
Practice Address - Country:US
Practice Address - Phone:302-428-2100
Practice Address - Fax:302-428-2121
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2013-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4392722084P0800X
DEC100107142084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry